Abstract
Abstract. Damage to the musculoskeletal system is one of the serious, but understudied complications of diabetes mellitus (DM). Inflammatory and/or degenerative structural changes in the joints against the background of long-term hyperglycemia in the initial stages cause limitation of joint mobility, and later lead to persistent contractures and disability of patients. Therefore, the studying formation mechanisms of joint lesions in patients with DM is extremely important and relevant. The aim of our study was to identify the levels of specific hormones and biochemical markers of connective tissue metabolism in patients with diabetic arthropathy and to establish their possible influence on the development of joint pathology in this category of patients. Material and methods. The presence and degree of severity of diabetic arthropathy was assessed according to the method of A. Rosenblum. Levels of insulin, leptin, and osteocalcin in blood serum were determined by enzyme-linked immunosorbent assay using Diaclone reagent kits (France) and a Stat fax 3200 tablet immunoenzymatic analyzer (USA). Collagenase activity was assessed according to the method developed by S. Lindy and J. Halme. Glycosaminoglycans were determined by the Orcin method described by S.A. Klyatsky and R.I. Lifshits. Hydroxyproline fractions were isolated from blood serum according to the method proposed by S. Frey. And hydroxyproline was identified using reagents produced by Merck (Germany). Results. As a result of the study, it was found that the development of arthropathy did not depend on the type of DM. The odds of developing arthropathy were the same in men and women with type 1 DM (T1DM). Women with type 2 DM (T2DM) were 6.4 times more likely to develop arthropathy than men. It was established that in both types of DM, an increase in insulin and leptin levels was observed along with the progression of arthropathy. Osteocalcin levels were 53.9% higher in patients with T1DM and arthropathy than in patients without arthropathy. Regardless of the type of DM, patients with arthropathy had an increased level of biochemical markers indicating catabolic processes in the connective tissue of collagenase and free hydroxyproline. Conclusion. Thus, the important role of the hormones insulin and leptin in the development of lesions of the articular system in patients with DM has been established. Determination of osteocalcin, collagenase and hydroxyproline levels was an important early marker of catabolic processes in patients with diabetic arthropathy.
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